Effect of Variant Histopathology on Survival in Prostate Adenocarcinoma

Abstract

Purpose: It was aimed to determine the possible effects of variant pathology associated with prostate adenocarcinoma on survival. Material and Methods: Data of patients who underwent radical prostatectomy for localized prostate cancer between January 2014 and 2020 were retrospectively analyzed. The survival rates according to the presence of variant histology associated with prostate adenocarcinoma were analyzed and compared in relation to the clinical and demographic data of the cases. Results: A total of 244 patients were operated for localized prostate cancer. Preoperative The ISUP grades and percentages of the patients were respectively as ISUP 1 (42%), ISUP 2 (38%), ISUP 3 (10%) and ISUP > 3 (10%). Variant histopathology was present in 26% of the patients [intraductal (81%), foamy cell (11%), ductal (6%) and neuroendocrine (2%)]. When prostate cancer and prostate cancer associated with variant histopathology groups were compared, the mean age and postoperative 1st month PSA values were 62.29± 6.36 vs 64.33± 5.77 years p=(0.025) and 0.32± 1.53 and 1.01± 2.98 ng/dl (p=0.022) respectively. Mean follow-up time for prostate cancer and prostate cancer associated with variant pathology was statistically similar (60.33±21.66 vs. 60.42±16.88 months). The mortality rates of the patients with and without variant histopathology were respectively as 11% and 14% (p=0.416). Conclusions: Associated variant pathology does not show a statistically significant decrease in survival rates of patients with localized prostate cancer receiving standard therapy. Rather, advanced age may have a role in the non-significant 3% difference in survival rate.